Revised long version (KEZ-R) and short form (KEZ-S) of the Cologne Questionnaire on Attitudes towards Coercive Measures in in-patient mental healthcare.

BACKGROUND

Attitudes of mental health professionals towards coercive measures are crucial with respect to both the application of these methods and efforts to reduce coercion in psychiatric care. Existing instruments primarily assess cognitive aspects, often neglecting emotional and contextual dimensions. The Cologne Questionnaire on Attitudes towards Coercive Measures (KEZ) addresses these gaps but has so far only been available in German and in a relatively long format.

AIMS: To revise the KEZ for international use and develop and validate a short version suitable for both research and clinical practice. The revised version was intended to ensure a balanced representation of different coercive measures.

METHOD: A revised long version (KEZ-R) was developed and administered via an anonymous online survey to 611 mental health professionals from Germany and German-speaking Switzerland. Psychometric properties of the German version were analysed using factor and reliability analyses. A short form (KEZ-S) was derived on the basis of theoretical and content-related criteria.

RESULTS

The 40-item KEZ-R replicated the original three-factor structure of the KEZ and showed good reliability (Cronbach's α = 0.87). The 15-item KEZ-S demonstrated strong correlation with the long version and acceptable overall reliability (α = 0.67). Both versions captured cognitive, emotional and interactional aspects of attitudes towards coercive measures.

CONCLUSIONS

The KEZ-R and KEZ-S are reliable instruments for assessment of attitudes towards coercive measures in psychiatric settings. Although validation was conducted in German, the availability of an English translation supports international use and future validation studies.